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dc.contributor.advisorReynolds, John
dc.contributor.authorHolland, Jane Catherine
dc.date.accessioned2016-12-15T12:17:35Z
dc.date.available2016-12-15T12:17:35Z
dc.date.issued2006
dc.identifier.citationJane Catherine Holland, 'The effect of major surgery on systemic and splanchnic immune function : examining the two-hit and gut hypotheses of the systemic inflammatory response syndrome', [thesis], Trinity College (Dublin, Ireland). School of Medicine. Discipline of Surgery, 2006, pp 271
dc.identifier.otherTHESIS 8052
dc.identifier.urihttp://hdl.handle.net/2262/78423
dc.description.abstractThe systemic inflammatory response syndrome (SIRS), sepsis and multiple organ dysfunction syndrome (MODS) are recognized sequelae of complex major surgery and underlie significant morbidity and mortality. The systemic immunoinflammation underlying SIRS and MODS in the presence or absence of infection is not fully understood, but two of the current hypotheses are the ‘two-hit’ and gut hypotheses. The ‘two-hit’ hypothesis proposes that if the host immune system has been primed by an initial insult, the immune response to any subsequent or second msult will be greatly amplified. The gut hypothesis incriminates bacteria and endotoxins derived from the gastrointestinal tract as triggers, which initiate, perpetuate or exacerbate a systemic inflammatory response resulting in the development of SIRS. In this work, a cohort of patients undergoing curative surgery for upper gastrointestinal malignancy was studied, some of who received neoadjuvant chemoradiotherapy. The acute-phase response was assessed by measurement of C-reactive protein levels. T-cell and monocyte function were assessed by measuring expression of activation markers on these cells in vivo, while neutrophil function was assessed by measurement of intranuclear NF-kappa B in vivo. Intraoperative measurement of splanchnic blood flow was performed by means of gastric tonometry, while pre- and postoperative gut function was estimated by measurement of intestinal permeability.
dc.format1 volume
dc.language.isoen
dc.publisherTrinity College (Dublin, Ireland). School of Medicine. Discipline of Surgery
dc.relation.isversionofhttp://stella.catalogue.tcd.ie/iii/encore/record/C__Rb13058658
dc.subjectSurgery, M.D.
dc.subjectM.D. Trinity College Dublin
dc.titleThe effect of major surgery on systemic and splanchnic immune function : examining the two-hit and gut hypotheses of the systemic inflammatory response syndrome
dc.typethesis
dc.type.supercollectionthesis_dissertations
dc.type.supercollectionrefereed_publications
dc.type.qualificationlevelBachelor of Science
dc.type.qualificationnameDoctor of Medicine (M.D.)
dc.rights.ecaccessrightsopenAccess
dc.format.extentpaginationpp 271
dc.description.noteTARA (Trinity’s Access to Research Archive) has a robust takedown policy. Please contact us if you have any concerns: rssadmin@tcd.ie


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